U.S. District Court, District of New Mexico Contract Interpreter Authorization Voucher PAID BY Interpreter: MATTHEW J. DYKMAN, CLERK U.S. DISTRICT COURT 4651 Social Security/Tax ID Number: Mailing Address: Contract/BPA Number: City/State/Zip: I hereby request payment be made for interpretation services requested and performed in: Spanish Navajo Other (specify) No Yes AO Certified or Professionally Qualified? Check will be made out to above named interpreter unless indicated as follows: TIME Judge, U.S. Probation Officer or U.S. Pretrial Officer DATE From RATES: Certified and PQ: Non-Certified: To Full Day Half Day $ 388 $ 210 $ 187 $ 103 CASE NO. OT/hr $ 55 $ 32 1a. Day(s): x 1b. Half Day(s): per half day 2. Overtime Hr(s): x Continue on page 2 if necessary per full day x DEFENDANT OR WITNESS NUMBER PROCEEDING per hour OT 3a. Mileage (when authorized *) 1. Fees (a+b) 2. Overtime x $ .51 per mile $0.00 3. Mileage * Must be 30 miles or more, one way. Include date and times of departure/arrival, below. Line 4 and 5: Overnight trips only -- totals must match corresponding fields on Itemized Travel Voucher. Departure from residence 4. Transportation Arrival at court destination 5. Subsistence Departure from court location 6. Other Arrival at residence $0.00 TOTAL I certify that I rendered the services described herein, that said services were rendered in accordance with the Contract Court Interpreter Services Terms and Conditions, and that no other federal court unit, Federal Public Defender, Community Defender Organization, or other attorneys or entities obtaining interpreting services under the CJA of the Defender Services appropriation has been or will be billed for the same period of service, cancellation or travel expenses. Date: Signature: Pursuant to the authority vested in me, I certify that the voucher is correct and proper for payment. Approved for Payment: Title: Date: ACCOUNTING CLASSIFICATION - 092000 - DXXBBCX - D10NMX Rev. 01/05/11 - 2523 Page of American LegalNet, Inc. www.FormsWorkFlow.com Contract Interpreter Authorization Voucher Page of Interpreter: TIME DATE From Rev. 01/05/11 To Judge, U.S. Probation Officer or U.S. Pretrial Officer CASE NO. PROCEEDING DEFENDANT OR WITNESS NUMBER American LegalNet, Inc. www.FormsWorkFlow.com